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132nd MAINE LEGISLATURE
SECOND REGULAR SESSION-2026
Legislative Document No. 2119
H.P. 1434 House of Representatives, January 7, 2026
An Act to Expand Reimbursement for Treatment in Place,
Community Paramedicine and Alternate Destination Transport
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule
203.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative DEBRITO of Waterville.
Cosponsored by Representatives: ARATA of New Gloucester, DUCHARME of Madison,
Speaker FECTEAU of Biddeford, ROEDER of Bangor, SALISBURY of Westbrook, Senators:
CURRY of Waldo, MOORE of Washington.
Page 1 - 132LR2793(01)
1Be it enacted by the People of the State of Maine as follows:
2Sec. 1. 22 MRSA §3174-QQQ is enacted to read:
3§3174-QQQ. Reimbursement for ambulance services
41. Reimbursement for ambulance services. The department shall provide
5 reimbursement under the MaineCare program for ambulance services, including:
6 A. Emergency transport to a hospital;
7 B. Treatment provided on the scene in response to an emergency call, regardless of
8 transport;
9 C. Care provided by an emergency medical services provider through community
10 paramedicine as defined in Title 32, section 84, subsection 4 through approved
11 community paramedicine services as described in Title 32, section 84, subsection 4;
12 and
13 D. Transport of a patient to an alternate destination. As used in this paragraph,
14 "alternate destination" means a facility other than a hospital emergency department that
15 is clinically appropriate for the patient's condition, including, but not limited to, an
16 urgent care center, federally qualified health center, primary care practice, behavioral
17 health crisis center, substance use treatment facility or other clinically appropriate site,
18 as permitted by the Department of Defense, Veterans and Emergency Management,
19 Maine Emergency Medical Services.
202. Rules. The department shall adopt rules to implement this section. Rules adopted
21 pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375,
22 subchapter 2-A.
23Sec. 2. 24-A MRSA §4303-F, sub-§1, as amended by PL 2025, c. 34, §1 and
24 affected by §2, is further amended by repealing the first blocked paragraph.
25Sec. 3. 24-A MRSA §4303-F, sub-§5 is enacted to read:
265. Required reimbursement for ambulance services. A carrier that provides
27 coverage for emergency medical services shall reimburse for ambulance services,
28 including:
29 A. Emergency transport to a hospital;
30 B. Treatment provided on the scene in response to an emergency call, regardless of
31 transport;
32 C. Care provided by an emergency medical services provider through community
33 paramedicine as defined in Title 32, section 84, subsection 4 through approved
34 community paramedicine services as described in Title 32, section 84, subsection 4;
35 and
36 D. Transport of a patient to an alternate destination. As used in this paragraph,
37 "alternate destination" means a facility other than a hospital emergency department that
38 is clinically appropriate for the patient's condition, including, but not limited to, an
39 urgent care center, federally qualified health center, primary care practice, behavioral
40 health crisis center, substance use treatment facility or other clinically appropriate site,
Page 2 - 132LR2793(01)
41 as permitted by the Department of Defense, Veterans and Emergency Management,
42 Maine Emergency Medical Services.
3Sec. 4. Rulemaking. The Department of Health and Human Services, in
4 consultation with the Department of Defense, Veterans and Emergency Management,
5 Maine Emergency Medical Services, shall adopt rules to implement this Act, including, but
6 not limited to:
7 1. Establishing clinical and documentation standards for treatment provided on the
8 scene in response to an emergency call, care provided by an emergency medical services
9 provider through community paramedicine and alternate destination transport;
10 2. Establishing billing and coding procedures; and
11 3. Establishing quality assurance and patient safety requirements.
12 Rules adopted under this section are routine technical rules as defined in the Maine
13 Revised Statutes, Title 5, chapter 375, subchapter 2-A.
14SUMMARY
15 This bill expands existing requirements for insurance carriers and the MaineCare
16 program to provide reimbursement for ambulance services to include:
17 1. Treatment provided on the scene in response to an emergency call, regardless of
18 transport;
19 2. Care provided by an emergency medical services provider through community
20 paramedicine; and
21 3. Alternate destination transport to clinically appropriate facilities other than hospital
22 emergency departments.
23 The bill requires the Department of Health and Human Services and the Department of
24 Defense, Veterans and Emergency Management, Maine Emergency Medical Services to
25 adopt rules to implement reimbursement standards.
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